Provider Demographics
NPI:1104939404
Name:SANTIAGO DE SNYDER, SOAMI (PHD IN AUDIOLOGY)
Entity type:Individual
Prefix:DR
First Name:SOAMI
Middle Name:
Last Name:SANTIAGO DE SNYDER
Suffix:
Gender:F
Credentials:PHD IN AUDIOLOGY
Other - Prefix:MRS
Other - First Name:SOAMI
Other - Middle Name:SANTIAGO
Other - Last Name:SANTIAGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD IN AUDIOLOGY
Mailing Address - Street 1:PO BOX 370624
Mailing Address - Street 2:INSTITUTO DE AUDIOLOGIA AVANZADA
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00737
Mailing Address - Country:US
Mailing Address - Phone:787-738-8850
Mailing Address - Fax:787-738-8850
Practice Address - Street 1:AVE ANTONIO R BARCELO
Practice Address - Street 2:SUITE 212 SIERRA CAYEY MALL
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736-3717
Practice Address - Country:US
Practice Address - Phone:787-738-8850
Practice Address - Fax:787-738-8850
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR38129231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR60249Medicare ID - Type Unspecified